Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction
Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral re...
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| Published in: | BJUI compass Vol. 5; no. 12; pp. 1255 - 1262 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
John Wiley & Sons, Inc
01.12.2024
John Wiley and Sons Inc Wiley |
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| ISSN: | 2688-4526, 2688-4526 |
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| Abstract | Introduction
Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction.
Methods
We conducted a single‐centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non‐White) and ethnicity (Hispanic vs. non‐Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney U tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression.
Results
Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non‐White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture‐free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non‐White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non‐White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths.
Conclusion
This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non‐White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. |
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| AbstractList | Introduction
Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction.
Methods
We conducted a single‐centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non‐White) and ethnicity (Hispanic vs. non‐Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney U tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression.
Results
Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non‐White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture‐free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non‐White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non‐White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths.
Conclusion
This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non‐White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. Abstract Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction. Methods We conducted a single‐centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non‐White) and ethnicity (Hispanic vs. non‐Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney U tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression. Results Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non‐White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture‐free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non‐White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non‐White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths. Conclusion This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non‐White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction. Methods We conducted a single‐centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non‐White) and ethnicity (Hispanic vs. non‐Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney U tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression. Results Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non‐White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture‐free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non‐White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non‐White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths. Conclusion This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non‐White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction. We conducted a single-centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non-White) and ethnicity (Hispanic vs. non-Hispanic). Statistical analyses included Kruskal-Wallis, Mann-Whitney tests, ANOVA, Kaplan-Meier analysis and multivariate logistic regression. Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non-White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture-free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non-White patients (26.9% vs. 16.0%; = 0.043). Unadjusted and adjusted regressions showed significant associations between non-White race (unadjusted = 0.76, = 0.008; adjusted = 0.82, = 0.008) and Hispanic ethnicity (unadjusted = 0.70, = 0.025; adjusted = 0.79, = 0.020) with increased stricture lengths. This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non-White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction.IntroductionUreteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction.We conducted a single-centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non-White) and ethnicity (Hispanic vs. non-Hispanic). Statistical analyses included Kruskal-Wallis, Mann-Whitney U tests, ANOVA, Kaplan-Meier analysis and multivariate logistic regression.MethodsWe conducted a single-centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non-White) and ethnicity (Hispanic vs. non-Hispanic). Statistical analyses included Kruskal-Wallis, Mann-Whitney U tests, ANOVA, Kaplan-Meier analysis and multivariate logistic regression.Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non-White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture-free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non-White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non-White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths.ResultsOur cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non-White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture-free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non-White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non-White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths.This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non-White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access.ConclusionThis study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non-White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. |
| Author | Ahmadieh, Kian Delgado, Cesar Cedars, Benjamin Cho, Eric Pan, Michael Puri, Dhruv Buckley, Jill C. Witthaus, Michael Garg, Nishant |
| AuthorAffiliation | 1 Department of Urology UC San Diego School of Medicine La Jolla California USA 4 Kelsey‐Seybold Clinic Houston Texas USA 2 Kaiser Permanente, Redwood City Medical Center San Francisco California USA 3 University of Maryland Capital Region Medical Center Baltimore Maryland USA |
| AuthorAffiliation_xml | – name: 2 Kaiser Permanente, Redwood City Medical Center San Francisco California USA – name: 3 University of Maryland Capital Region Medical Center Baltimore Maryland USA – name: 4 Kelsey‐Seybold Clinic Houston Texas USA – name: 1 Department of Urology UC San Diego School of Medicine La Jolla California USA |
| Author_xml | – sequence: 1 givenname: Dhruv orcidid: 0000-0001-6657-0135 surname: Puri fullname: Puri, Dhruv email: dhruvpuri1997@gmail.com organization: UC San Diego School of Medicine – sequence: 2 givenname: Eric surname: Cho fullname: Cho, Eric organization: Kaiser Permanente, Redwood City Medical Center – sequence: 3 givenname: Kian surname: Ahmadieh fullname: Ahmadieh, Kian organization: UC San Diego School of Medicine – sequence: 4 givenname: Nishant surname: Garg fullname: Garg, Nishant organization: UC San Diego School of Medicine – sequence: 5 givenname: Cesar surname: Delgado fullname: Delgado, Cesar organization: UC San Diego School of Medicine – sequence: 6 givenname: Benjamin surname: Cedars fullname: Cedars, Benjamin organization: UC San Diego School of Medicine – sequence: 7 givenname: Michael surname: Witthaus fullname: Witthaus, Michael organization: University of Maryland Capital Region Medical Center – sequence: 8 givenname: Michael surname: Pan fullname: Pan, Michael organization: Kelsey‐Seybold Clinic – sequence: 9 givenname: Jill C. surname: Buckley fullname: Buckley, Jill C. organization: UC San Diego School of Medicine |
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| Cites_doi | 10.1200/JCO.20.02602 10.1097/SPV.0000000000001302 10.1007/s00345-023-04525-6 10.1016/j.urology.2020.09.025 10.1007/s11606-011-1776-8 10.1093/ofid/ofab276 10.1007/s11255-023-03906-5 10.1016/j.urology.2021.08.037 10.1038/s41391-022-00508-7 10.1086/677827 10.1016/j.urology.2023.12.003 10.1016/j.juro.2012.08.242 10.3389/fpubh.2022.969370 10.4103/UA.UA_110_18 10.1177/1524839921993044 10.1002/bco2.267 10.1097/CU9.0000000000000107 10.1016/j.amepre.2018.05.012 10.1016/s0027-9684(15)30498-3 10.1377/hlthaff.2021.00139 10.1038/nrurol.2012.254 10.7759/cureus.11234 10.1016/j.urology.2021.10.038 10.1016/j.urology.2010.05.055 10.1016/j.urology.2021.05.023 |
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| Keywords | health disparities ureteral stricture disease race and ethnicity robot‐assisted ureteroplasty |
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Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in... Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes... Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in... Abstract Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities... |
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| SubjectTerms | Clinical outcomes Ethnicity health disparities Original race and ethnicity robot‐assisted ureteroplasty ureteral stricture disease |
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| Title | Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction |
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